Tobacco studies often combine data for Asian American and Native Hawaiian and Other Pacific Islander (AANHOPI) subgroups, masking subgroup differences. A newly published study describes tobacco use (ever use and past 30-day use) among some disaggregated AANHOPI subgroups. Data from Wave 1 of the 2013-2014 Population Assessment of Tobacco and Health (PATH) Study were analyzed. The dataset contains a sample of 32,320 adults, of which 1623 identified as being of AANHOPI origin. Asian Americans further identified as being Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or other Asian. Those who identified as Native Hawaiian, Guamanian or Chamarro, Samoan, and Other Pacific Islander were combined into an NHOPI group.
· Asian Indians and Chinese had the lowest and NHOPI had the highest tobacco use prevalence compared to other AANHOPI subgroups.
· Males generally had higher prevalence compared to females.
· Prevalence varied by AANHOPI membership and tobacco product.
Tobacco use varies by AANHOPI subgroup and product type. Tobacco use differences in AANHOPI subgroups may be attributed to socio-economic status differences. The researcher concluded that treating these distinct subgroups as a monolithic group may contribute to reliance on tobacco prevention and control strategies that may have limited impact on specific subgroups.
Nguyen (2019). Disaggregating Asian American and Native Hawaiian and Other Pacific Islander (AANHOPI) Adult Tobacco Use: Findings from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, 2013-2014. Journal of Racial and Ethnic Health Disparities, Jan 4. doi: 10.1007/s40615-018-00532-1. [Epub ahead of print]
Water pipe with smoke
A newly published study assessed the contribution of substance use and stress/traumatic events to hookah use among African American college students (n = 1,402).
· Lifetime hookah use was 25%, with 34% of lifetime users having done so in the past 30 days.
· Compared to nonusers, hookah users had significantly higher use rates of alcohol, marijuana, other tobacco, and other drugs.
· Hookah use was more likely among those with cumulative stress, yet less likely among older students.
The researchers concluded that prevention messages may need to be tailored for African American college students and particularly target younger students, substance users, and those with cumulative stress.
Source: Cunningham-Williams et al. (2018). Stress, stressors, and substance use: Differential risk for hookah use among African American college students. Journal of Ethnicity in Substance Abuse, Oct 22:1-22. doi: 10.1080/15332640.2018.1511492. [Epub ahead of print]
Smoking cessation may promote long-term recovery in patients with substance use disorders (SUD). Yet smoking rates remain alarmingly high in this population. A recently published study examined smoking rates among hospitalized patients with SUD at a large safety-net hospital, and then characterized factors associated with smoking behaviors. Researchers analyzed data from all hospital admissions (7/2016-6/2017) and conducted semi-structured qualitative interviews with 20 hospitalized SUD smokers.
- Prevalence of cigarette smoking among hospitalized smokers with SUD was three times higher than those without SUD.
- Qualitative analyses showed that patients perceived that smoking cigarettes was a less serious concern than other substances.
- Some patients feared that quitting cigarettes could negatively impact their recovery and perceived that clinicians do not prioritize treating tobacco dependence.
- Almost all patients with heroin use disorder described how cigarette use potentiated their heroin high.
- Many SUD patients are turning to vaping and e-cigarettes to quit smoking.
The researchers concluded that hospitalized patients with SUD have disproportionately high smoking rates and perceive multiple barriers to quitting cigarettes. Smoking cessation interventions with this population should take into account how patients with SUD perceive smoking-related health risks and how that influences their decision to quit smoking.
Source: Kathuria et al. (2019). Perceived barriers to quitting cigarettes among hospitalized smokers with substance use disorders: A mixed methods study. Addictive Behaviors, Feb 18;95:41-48. doi: 10.1016/j.addbeh.2019.02.017. [Epub ahead of print]
A newly published study examined the characteristics and risk factors for preterm birth in Hawaiian and Pacific Islander women. Data from 10,470 women of Hawaiian or Pacific Islander descent in California were analyzed. Hawaiian/Pacific Islander women were at higher risk for preterm birth when they had fewer than three prenatal visits; were underweight, reported tobacco, alcohol, or illicit drugs use in pregnancy; had a diagnosis of anemia, gestational diabetes, preexisting diabetes, or hypertension with or without pre-eclampsia; or had a history of previous preterm birth.
Source: Altman et al. (2018). Patterns of Preterm Birth among Women of Native Hawaiian and Pacific Islander Descent. American Journal of Perinatology, Dec 21. doi: 10.1055/s-0038-1676487. [Epub ahead of print]
Lower rates of successful quitting among low-income populations in the United States may be from slower dissemination of smoke-free homes, a predictor of cessation. A recently published study explored the role of smoke-free homes in cessation behavior across income levels. Researchers analyzed data from the 2002-2003 (n = 2801) and 2010-2011 (n = 2723) Tobacco Use Supplements to the Current Population Survey.
- Between the two surveys, heavy smoking (≥ 1 pack/day) declined by 17%, and smoking prevalence declined by 15% among those with higher-incomes.
- Although similar in 2002, the prevalence of smoke-free homes was 33% lower among individuals living <300% FPL than those living ≥300% FPL.
- Whereas smoking ≥ 1 pack/ day was associated with lower odds of 30+ days abstinence, having a higher income and a smoke-free home were associated with greater odds of 30+ day abstinence.
The researchers concluded that increasing the diffusion of smoke-free homes among low-income populations may attenuate at least a third of the income disparities in smoking cessation, highlighting the need for interventions to increase adoption of smoke-free homes among low-income households.
Source: Vijayaraghavan et al. (2018). Income disparities in smoking cessation and the diffusion of smoke-free homes among U.S. smokers: Results from two longitudinal surveys. PloS One, Jul 27;13(7):e0201467. doi: 10.1371/journal.pone.0201467. eCollection 2018.
Young adults have high smoking rates and low utilization of evidence-based smoking cessation strategies. A recently published study investigated smoking cessation intentions, strategy use, and socioeconomic predictors of strategy use among young adult smokers (age 18-24) and compared patterns to those of older adults (age 25-64).
· Young adults planned to quit on a longer time frame, expressed lower interest in quitting, and were more confident they would be successful, compared to older adults.
· Young adults were significantly less likely to use pharmacotherapy.
· Both groups reported using product substitution, primarily with e-cigarettes, more than any evidence-based cessation strategy.
· Socioeconomic predictors of cessation strategy use did not differ between age groups.
The researchers concluded that more research on why young adult smokers underutilize evidence-based cessation support is needed, as are innovative efforts to increase intentions to quit and utilization of cessation assistance.
Source: Watkins et al. (2018). Cold Turkey and Hot Vapes? A national study of young adult cigarette cessation strategies. Nicotine & Tobacco Research, Dec 26. doi: 10.1093/ntr/nty270. [Epub ahead of print]
A recently published study explored the effect of tobacco retailer density, neighborhood poverty, and housing type (multiunit and public) on smoking in a large urban environment (New York City). Researchers analyzed data on smoking prevalence and individual sociodemographic characteristics from the 2011-2013 New York City Community Health Survey, data on tobacco retailers from the 2012 New York City Department of Consumer Affairs, data on neighborhood sociodemographic characteristics and population density from the 2009-2013 American Community Survey, and data on multiunit and public housing from the 2012 New York City Primary Land Use Tax Lot Output data set.
- Neighborhood poverty positively and significantly modified the association between tobacco retailer density and prevalence of neighborhood smoking.
- Neighborhood poverty was positively associated with the prevalence of individual smoking.
Source: Farley et al. (2019). The Influence of Tobacco Retailer Density and Poverty on Tobacco Use in a Densely Populated Urban Environment. Public Health Reports, Mar/Apr;134(2):164-171. doi: 10.1177/0033354918824330. Epub 2019 Feb 14.
A newly published study examined changes in prevalence of e-cigarette use and perceptions of the harmfulness of e-cigarette and combustible cigarettes following a campus-wide tobacco ban. Undergraduate students completed surveys of tobacco use and perceived product harmfulness. Four samples were collected: in 2013 prior to the ban (n = 792) and in fall 2014 (n = 310), 2015 (n = 208), and 2016 (n = 417).
- E-cigarette use increased in the years following the ban while combustible cigarette use decreased from 2013 to 2016.
- Men were more likely than women to use both products.
- Students’ perceptions of the harmfulness of combustible and electronic cigarettes remained stable in the years following the ban.
Source: Leavens et al. (2019). Electronic cigarette and combustible cigarette use following a campus-wide ban: Prevalence of use and harm perceptions. Journal of American College Health, Jan 25:1-4. doi: 10.1080/07448481.2018.1551803. [Epub ahead of print]
A recently published study examined the burden of tobacco and substance use disorders among hospitalized heart failure patients in the United States.
- Of 989,080 heart failure hospitalizations, 16% had documented tobacco or substance use disorder.
- Female sex was associated with lower rates of tobacco and substance use disorder.
- Tobacco and substance use disorder rates were highest for hospitalizations <55 years of age.
- Medicaid insurance or income in the lowest quartile were associated with increased risk of tobacco and substance use disorders.
The researchers concluded that enhanced screening for tobacco and substance use disorders in hospitalized heart failure patients may reveal opportunities for treatment and secondary prevention.
Source: Snow et al. (2018). National Rate of Tobacco and Substance Use Disorders Among Hospitalized Heart Failure Patients. The American Journal of Medicine, Dec 16. pii: S0002-9343(18)31168-9. doi: 10.1016/j.amjmed.2018.11.038. [Epub ahead of print]
Few studies have focused on understanding how sociodemographic factors impact healthy ageing in the rapidly growing population of Alaskan older adults. A newly published study compared the health of Alaskan older adults to those in the contiguous US, and determined how the associations differ between older adults in Alaska and the contiguous US.
· In the contiguous US, females were less likely than males to be obese, while in Alaska, females were more likely to be obese.
· In the contiguous US, Alaska Natives/American Indians were more likely than respondents of other races to be smokers, while in Alaska, the association between race and smoking was not significant.
· These differences between Alaska and the contiguous US results suggest that programs designed to reduce disparities and promote healthy behaviours may need to be tailored to meet the unique needs and challenges of older adults living in Alaska.
Source: Cohen et al. (2019). Disparities in social determinants of health outcomes and behaviours between older adults in Alaska and the contiguous US: evidence from a national survey. International Journal of Circumpolar Health, Dec;78(1):1557980. doi: 10.1080/22423982.2018.1557980.